405 IAC 5-19-17 Pneumatic artificial voicing systems

Sec. 17. (a) Medicaid reimbursement is available for a pneumatic artificial voicing system or an artificial larynx, subject to prior authorization. Prior authorization will be granted only upon satisfaction of the following: (1) Documentation must be presented that substantiates the member has demonstrated sufficient mental and physical capabilities to benefit from the use of the system. (2) Documentation must be presented that substantiates the member has demonstrated sufficient articulation and language skills to benefit from the use of the system. (b) When a pneumatic artificial voicing system or an artificial larynx is provided on an inpatient basis, the attendant costs are considered to be included in the established per diem rate for the hospital or long term care facility and are not to be separately billed to Medicaid.